Job description
Job Summary
Two openings: one ~2-month assignment, one ~6-month assignment
Location: Fully remote
Reports to: Billing Manager
About the Role
A nonprofit human services organization is seeking two temporary Medical Billing Specialists. The Billing Specialists will play a key role in ensuring accurate and timely processing of claims, eligibility verification, and reimbursement for services delivered to clients.
Key Responsibilities
- Enter service data into Alameda County's behavioral health EHR (SmartCare) and reconcile entries to ensure billing accuracy
- Verify client eligibility through California's Medi-Cal provider portal and the commercial clearinghouse (Optum Revenue Performance Advisor)
- Communicate eligibility changes, lapses, and coverage updates to the Quality Assurance team and direct care staff
- Maintain and manage client records within SmartCare
- Prepare, submit, and track insurance claims, including coding diagnoses and procedure codes
- Monitor claims for timely submission; investigate and resolve billing inaccuracies
- Bill and collect copays/deductibles from parents and guardians where applicable
- Review billing denial queues and resubmit claims as needed
- Reconcile payments, work with payers to appeal and correct errors, and resolve discrepancies
- Maintain proper documentation for each claim, including approvals and denials
- Stay current on changes in billing codes, regulations, and payer policies
Qualifications
- Education and experience: Bachelor's degree, OR Associate degree plus 1 year of relevant experience, OR high school diploma/GED plus 2 years of relevant experience
- 1-2 years of experience in medical billing, data entry, claims processing, or revenue cycle billing
- Familiarity with Medi-Cal and commercial insurance payors strongly preferred
- Prior experience with SmartCare, Optum Revenue Performance Advisor, or similar EHR/clearinghouse systems is a plus
- Some experience with accruals and AP/credit card reconciliation a plus
- Strong Excel skills
- Excellent organizational, analytical, and problem-solving abilities
- Detail-oriented with proven ability to manage and track large volumes of information
- Strong written and verbal communication skills
- Must be at least 21 years of age
- Ability to clear TB test, fingerprinting, and any other state/federal licensing requirements